Assessment of Serum Lipoprotein(A) in Patients with End-Stage Renal Disease

Increased plasma lipoprotein(a) [Lp(a)] levels are strongly associated with premature atherosclerotic cardiovascular disease. The kidney is purported to play an important role in Lp(a) catabolism. However, race and genetic background to a large extent determine the Lp(a) concentrations in the general population. The aim of present study was to evaluate the effect of end-stage renal disease on serum Lp(a) in a group of Iranian population.
Sixty seven patients with end-stage renal disease treated by hemodialysis and 100 healthy controls were investigated. The lipids were measured by routine laboratory methods and Lp(a) assay was done by electroimmunodifusion.
The serum levels of Lp(a) in patients were significantly higher than controls (median 31 mg/dl versus 20 mg/dl, p=0.016). The Lp(a) in control group did not correlate with age, sex and lipids, but in patients it was found to correlate significantly with age (r=0.28, p=0.033), and cholesterol (r=0.35, p=0.008). In this study, 28% of controls and 54% of patients had serum Lp(a) above 30 mg/dl. This level is considered as cutoff point of high risk for atherosclerosis.
We concluded that end-stage renal disease could affect the serum lipids, Lp(a) and other lipoproteins towards atherogenic state in the Iranian population.